RESUMO
More than 50,000 patients were affected in Cuba during an epidemic outbreak of peripheral neuropathy from January 1992 until September 1993. The disease presented as either a retrobulbar optic neuropathy, a predominantly sensory peripheral neuropathy, a dorsolateral myeloneuropathy, or as mixed forms. The morphological findings in sural nerve biopsies from 34 patients with various forms of the disease are presented here. Frozen, paraffin and semi-thin sections were prepared for light and electron microscopy, immunohistochemistry and morphometric analysis. Every case presented morphological alterations ranging from mild axonal dystrophy (9 cases, or 27%) to moderate and severe axonal damage (25 cases, or 73%). In 6 cases (18%), axonal damage was accompanied by perineural fibrosis and vascular abnormalities. Axonal regeneration was noted in 8 cases (23%) and remyelination in 9 (26%). Morphometric analysis showed a predominant loss of myelinated fibers in 92% of the patients. Quantification of myelinated fiber loss in 11 patients revealed a remarkable decrease in large caliber fibers. Scarce mononuclear cells were observed in 17 cases. No virus-like elements were seen. The morphological features found in this study indicate that, regardless of the clinical presentation, peripheral nerve lesions of the epidemic neuropathy in Cuba correspond to an axonal neuropathy. These lesions are compatible with nutritional, toxic, or metabolic etiologies. An inflammatory etiology would be unusual with these lesions.
Assuntos
Doenças do Sistema Nervoso Periférico/patologia , Nervo Sural/patologia , Adulto , Idoso , Axônios/patologia , Beriberi/epidemiologia , Beriberi/patologia , Biópsia , Cuba/epidemiologia , Doenças Desmielinizantes/patologia , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas Mielinizadas/patologia , Doenças do Nervo Óptico/epidemiologia , Doenças do Nervo Óptico/patologia , Doenças do Sistema Nervoso Periférico/epidemiologiaRESUMO
A 20-year-old female patient who presented papylo-erythematous lesions with intense pruritus and arciform sinuous lesions in the back and gluteal regions during a stay at a beach is presented. A cutaneous larva migrans was diagnosed through biopsy. A brief bibliographic review of this parasitologic entity is made.
Assuntos
Larva Migrans/parasitologia , Adulto , Feminino , Humanos , Larva Migrans/tratamento farmacológico , Larva Migrans/patologia , Pele/parasitologia , Pele/patologia , Tiabendazol/uso terapêuticoRESUMO
Se presenta un caso de panhemocitopenia inmunológica que constituye la primera observación en Cuba y la tercera en el mundo como caso estudiado y diagnosticado y la novena como estadística.Se recomienda por su exquisitez la prueba biológica de Minscher y se destaca su importancia diagnóstica en este caso.La esplenectomía fue el procedimiento de elección por el hiperesplenismo y por ser el bazo, fundamentalmente, el órgano creador de dichos anticuerpos.Se comprueba postoperatoriamente la desaparición de 2 de dos de los anticuerpos, y las disminución considerable del tercer anticuerpo (plaquetario) que era el más potente y que, posiblemente, inicio el cuadro(AU)
Assuntos
Pancitopenia , Esplenectomia , HiperesplenismoRESUMO
Se presentan dos casos de poliarteritis nodosa a forma gangrenosa masiva de las extremidades inferiores, uno de los cuales requirió amputación de una de las extremidades y el otro amputación de ambas extremidades inferiores; confirmado este diagnóstico por el exámen histológico. Se destaca que no existen reportes de casos similares en la literatura mundial de esta que pudiéramos llamar, forma clínica de la enfermedad de Kussmaul y Maier (AU)
